The majority of tinnitus patients are affected by chronic idiopathic tinnitus, and almost 60 different treatment modalities have been reported. The present study is a multidisciplinary systematic analysis of the evidence for the different forms of treatment for chronic tinnitus. The results are used to form the basis of an S3 guideline. A systematic search was carried out in PubMed and the Cochrane Library. The basis for presenting the level of evidence was the evidence classification of the Oxford Centre of Evidence-based Medicine. Whenever available, randomised controlled trials were given preference for discussing therapeutic issues. All systematic reviews and meta-analyses were assessed for their methodological quality, and effect size was taken into account. As the need for patient counselling is self-evident, specific tinnitus counselling should be performed. Due to the high level of evidence, validated tinnitus-specific, cognitive behavioural therapy is strongly recommended. In addition, auditory therapeutic measures can be recommended for the treatment of concomitant hearing loss and comorbidities; those should also be treated with drugs whenever appropriate. In particular, depression should be treated, with pharmacological support if necessary. If needed, psychiatric treatment should also be given on a case-by-case basis. With simultaneous deafness or hearing loss bordering on deafness, a CI can also be indicated. For auditory therapeutic measures, transcranial magnetic or direct current stimulation and specific forms of acoustic stimulation (noiser/masker, retraining therapy, music, and coordinated reset) for the treatment of chronic tinnitus the currently available evidence is not yet sufficient for supporting their recommendation.

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Bei der Inclusionschromatographie werden die Gastmolekule im kristallinen Bereich eines gequollenen makromolekularen Gels eingeklemmt. Triacetylcellulose, die durch heterogene Acetylierung von Cellulose erhalten wurde, hat in diesen Bereichen eine lamellare Anordnung mit der Einheitlichkeit eines Kristallgitters. Die Inclusion zwischen diesen Lamellen richtet sich in erster Linie nach der Gestalt der eingeschlossenen Molekule, weniger oder gar nicht nach funktionellen Gruppen. In der asymmetrischen Umgebung sind die EinschluBbedingungen fur die beiden spiegelbildlichen Formen eines chiralen Molekiils so unterschiedlich, daB eine davon bevorzugt wird. Durch die Wahl geeigneter Losungsmittel wird diese Bindung reversibel und fuhrt zu einem Sorptionsgleichgewicht, auf dem sich ein chromatographisches Trennsystem aufbauen lafit. Damit kann in fast allen Fallen eine nachweisbare Racemattrennung erreicht werden. Sie ist noch begiinstigt, wenn am Asymmetriezentrum ein aromatischer Kern haftet, da dieser in den Nischen zwischen je zwei acetylierten Glucoseresten definiert includiert wird. In giinstigen Fallen werden schon in einer kurzen Trennsiiule vollstandige Racemattrennungen erhalten. Triacetylcellulose-Gel ist wegen seiner ungewohnlichen Spezifitaten auch fur normale chromatographische Stofftrennungen geeignet. Dabei ist ein Drehwertschreiber als zusatzlicher Detektor wertvoll. Chromatographic Resolution of RacematesIn inclusion chromatography the guest molecules are jammed in the crystalline sections of a swollen macromolecular gel. Triacetyl cellulose obtained by heterogeneous acetylation of cellulose shows a laminated arrangement within these sections which is similar in uniformity to a crystal lattice. The inclusion between the laminae is determined mainly by the shape of the included molecules, and only to a minor extent, if at, all byfunctional groups. In the asymmetric environment the conditions for inclusion of the two mirror image isomers of a chiral molecule are very different, so that one of the antipodes is preferentially bonded. By selection of a suitable solvent the bonding becomes reversible and a sorption equilibrium is established upon which a chromatographic separation system can be based. With such a system significant separations of racemic mixtures into their antipodes can be achieved in almost all cases. The separation is even more effective if one of the substituents at the asymmetric center is an aromatic nucleus, because then the aromatic ring is jammed in the niches between every two acetylated glucose units in a defined position. Thus, under favorable circumstances, complete separations of racemates can be performed even with short columns. Due to its outstanding specificities triacetyl cellulose gel is aIso useful for normal chromatographic separations. The use of a recording polarimeter as an additional detector has proven valuable.*) Korrespondenz bitte an diesen Autor richten. **) Herrn Prof. Dr. Karl Freudenherg in Verehrung zum 90. Geburtstag gewidmet.